I was recently diagnosed at 22 with OCD while I have unknowingly suffered from it since childhood. It’s getting progressively worse everyday. My psychologist offered me her number to call or text anytime but I don’t like to bother people. I’m not sure what to do. My two biggest symptoms, hand washing/showering and rituals with my hands, are out of control. Whenever my hands are idle I’m constantly doing hand rituals. It’s seriously hurting my skin and my joints/hand muscles are aching. What do you suggest?

A. In the beginning, therapy might seem frightening but it isn’t. The whole purpose of therapy is to remove the roadblocks that are in the way of your happiness. Right now, anxiety and fear are your roadblocks but this is correctable with therapy. Therapy works.

It’s important that you contact your psychologist, as she suggested you do. You don’t want to bother her but I highly doubt that she would see it that way. She would not have given you her phone number and instructed you to “call or text anytime.” She made a recommendation for treatment but you are not following it. That might be why your OCD symptoms are getting worse.

Contact your therapist. Describe your symptoms and ask for her advice. You will not be bothering her. Follow her instructions and this will give you the best possible chance at decreasing your anxiety. OCD is a highly treatable condition but only if you follow the treatment protocol. Please take care.

I have been in and out several times of a controlling relationship. Full of lies and hurt emotionally. Everytime something goes wrong, he comes running tell me sorry with open arms and he blames everything on me and makes me feel Im in the wrong with everything. And he is easily jealous. And I find myself shutting my family out. I know this is a harmful relationship but I don’t know why I can’t walk away from it. He manipulates me and I have been reading things up in this kind of relationship. He comes back and is sweet and I feel like I can change him, but then it goes back to going bad again. Everything seems so romantic and Im afraid to let him go. As soon as I get going with out him he comes back and make me feel bad. I need input on how to walk away for good. (age 20, from US)

A: It sounds like you have already done some reading on the subject which is good. I would suggest that you continue to educate yourself. Please look up information on the “cycle of violence” and the “power and control wheel.” These are two concepts that come from theories relating to domestic violence. Control is the real issue and that is what you are describing here.

Educating yourself on the patterns, relying on your support system of friends and family for strength, and cutting off all communication with him are the first steps. Respecting yourself enough to believe that you deserve better is also very important. It can be really hard to break up with someone that you may still have feelings for but realize the relationship is unhealthy. It’s especially hard to break up with someone who has controlled and manipulated you. That is why it is so important to get support.

Most domestic violence shelters either have counselors that work there or they keep lists of counselors they can refer to. I would suggest that you get connected with your local shelter for extra support. You deserve to be in a relationship with someone who respects you. Please give yourself that chance.

I was sexually abused several times as a child growing up by family members. I have notified my parents and am seeking help now. I was recently diagnosed with PTSD and moderate depression, and while I feel better just by finally receiving help, I can’t shake off the feeling that it’s worthless. I can’t bring myself to care about not only about myself, but about family, friends, future. Or my little sister. I was sexually abused to protect her because if I hadn’t willingly given myself, my abusers would’ve used her. Since then, I have hated my sister. I blame her and I try not to. Our relationship is so strained. Yet, I still find myself protective over her I certain situations that bring memories back, but she doesn’t care what I did for her or what happened to me. I hate her for it. I feel so isolated despite the help and I always find myself blaming my sister. She was only a toddler at the time and I miss being her older sister. Please, what should I do?

A: I am so sorry this happened to you. Your PTSD reaction includes feelings you are having toward your sister, as well as the lack of caring. All of this is part of the Post Traumatic Stress Disorder.

Since you are already receiving help, tell the therapist these reactions and feelings. He or she can help you sort this through. If the abuser is still around be certain there are safeguards in place so you do not have contact. This will help you recover much faster.

]]>http://psychcentral.com/ask-the-therapist/2015/03/02/child-sexual-abuse-sprouting-into-other-problems/feed/0How Do You Know when You Have Recovered?http://psychcentral.com/ask-the-therapist/2015/03/02/how-do-you-know-when-you-have-recovered/
http://psychcentral.com/ask-the-therapist/2015/03/02/how-do-you-know-when-you-have-recovered/#commentsMon, 02 Mar 2015 12:35:46 +0000http://psychcentral.com/ask-the-therapist/?p=34440

From the U.S.: Early this year in April I decided to try Molly for the first time. The high was amazing but it then led to a horrible comedown filled with anxiety and depression. I recovered from this but then 1 month later randomly got anxiety and depression again. In the summer, I tried SSRIs which made me worse (probably since MDMA acts on similar receptors) so I stopped them completely and have been using natural methods like supplements/exercise along with CBT and I’ve come really far in recovery (the depression is gone, only anxiety left). In therapy all that is suggested is to let go, do breathing techniques, etc. Exercise helps for sure but I don’t have much faith in meditation.

Also, how do you let go of a time limit for recovery?

I want to be back to my normal self 100% the same as before the drug but how do I know when that’s happened? Therapist says I’ll never be the same again since people change but I cannot accept that I NEED to be an EXACT copy of before with the EXACT same personality. My mind keeps checking every morning if I’m my normal self but if I’m even getting that thought it means I’m not.

A: Please listen to your therapist. She’s correct: Even if you had never used any drugs, you aren’t the same person you were last spring. No one is. We all grow and change to some extent every minute of every day. Your problem is not that you are different. Your problem is that you developed an anxiety disorder in the wake of your experience with drugs.

I’m glad you are in treatment. Do take it seriously. CBT, regular exercise and meditation can help. You may not have faith in meditation but that’s like not having faith in gravity. It works whether you have faith in it or not. Meditate regularly and seriously for a few months and you’ll see a difference.

My doctors are having a hard time determining if I am Bi-polar. I go through weeks of depression to the point of considering suicide than come out of it. I have panic attack where I get very nervous and angry but I am not sure if that counts as a manic episode. I will start breathing very quickly till the point of not taking in any oxygen, driving dangerously down the roads, cutting myself, threatening my boyfriend (the main one who takes care of me during these times) and generally I cannot remember much or any of the event. These sessions last about 3-4 hours and happen about 4 times a month. I am on prozac for my depression but since taking it I have gotten worse. Is there anything I can do to help this situation? My parents are not supportive of medication or being bi-polar so it’s hard for me to get help for a doctor.

A. I am sorry to hear that your parents are not supportive of your receiving help. Even so, don’t let that stop you from seeking help. Understandably you’d probably rather have their support than not have it but you don’t have that option right now. Fortunately, your boyfriend seems supportive but he alone is not enough. Mental health problems require professional treatment, especially when self-harm and suicidal thoughts are involved.

Regarding your medication, it might be that you haven’t taken it long enough for it to fully work. Some medications can take four to eight weeks to take full effect. It may also be that you’re taking the wrong medication. It’s important to report your worsening condition to your prescribing doctor. He or she can make adjustments accordingly.

When meeting with your doctor, ask for a referral to a therapist. A therapist can determine your diagnosis and provide the necessary treatment for your symptoms. Medication is helpful in treating many mental health problems but often, it’s not enough. Therapy is a necessary component in the treatment of most mental health disorders. Often, you should not have one without the other.

With therapy and the right medication, your symptoms can be controlled. Please take care.

When a family member like my mom or dad kisses me and hugs me, I feel disgusted/nasty/dirty/powerless, etc. probably because I see hugs and kisses as something inherently sexual, so I like affection from anyone who isn’t my family. I cried when a couple hours ago my mom forced me to hug her. I had extreme anxiety when I was a preteen (not as extreme today), and I self-cut a few times in those times. I pick my scabs compulsively. Until I was ten or eleven, I had to sleep with my mom at my side, and even afterwards I slept alone but had to turn on the lights, and often woke up feeling like I was choking (still do). Most of my nightmares were about being persecuted and wanting to hide. Generally I wanted to hide all the time, from anyone i.e. I was in the living room and someone came in and I felt the rush to hide behind the bookshelf. I can’t stand my mom staring at me, and I don’t understand why I take it so much against her when I doubt she did anything. I also feared water on my face (even today I have to press the sides of my nose before getting my face under the showerhead so I don’t ”drown”). For this fear I couldn’t learn to swim. I also didn’t eat much then and had (and still have) trouble swallowing, and often nearly choked on food and drinks. What makes me suspect it the most is that before being even near puberty I used to get my dolls naked and play with them in the shower, and touched their breasts and so on, I also thought sexually of many of my other toys yet I didn’t know much about how sex really worked. I even have a slight fetish for older men although they scare me. I didn’t masturbate so early (probably not til 12 years old) but now I masturbate very very often, more than most girls (twice or three times a day). I well remember being pretty sexual in my childhood and I don’t know when exactly it started or what triggered it. I don’t remember anything that could explain this. Do you think I might have been abused sexually but I suppressed the memory? (age 17,from Mexico)

A: Thank you for writing in with your question and for including so many details. As much as I’d like to give you a definitive answer, I’m unable to do so. Some of your symptoms could certainly lead to suspicions of abuse, but some could be explained in other ways. For instance, your description of your behavior with your dolls: sexualized behavior in children who should not yet know what sex is can be indicative of sexual abuse, but some sexual curiosity, and even exploration, is quite normal. The frequency of your masturbation is also probably higher than most for females your age, but you may have associated the feelings to self-soothing attempts and reinforced the behavior in ways that others don’t.

Some of the problems you have listed can be anxiety related, such as fear of sleeping alone and in the dark, your fears of water on your face and your self-harm behavior, but again, it could mean that something traumatic happened to you that initiated the fears. I do think it is odd that you have such negative reactions to affection from family members.

I think your best bet would be to find a therapist to work with. Not only may therapy help you explore the possibility of repressed abuse, but more importantly, it will help you reduce the unwanted behaviors and symptoms that you are having.

My 2 year old is throwing tantrums and screaming almost every day all day long. Literally every 10 minutes something else come up. If I look at her, she will scream ‘no mommy looking, no mommy looking’. She asks for a tea, I give her tea she throws it away and starts screaming hot, no tea, no tea. she is crying all day long. I mean every little thing upsets her. It is out of proportion. Is it normal at this age?

Her dad and I are separated and shes seeing him 3 days a week and 4 days she’s with me. Is it psychological issues? Maybe my stress and changing homes are affecting her? Maybe she’s asking for my attention? Is it a normal behavior for toddlers in general? I know they are fussy and temperamental but how much is too much? It is driving me crazy and I am losing it!

Also, I wanted to know how to react to these tantrums? Punishing her doesn’t seem right. Talking to her during the tantrum makes her mad even more.

Just ignore them? I don’t know what to do. It is so frustrating
Please help me understand what is that my child wants to tell me.
Thanks!

A: Children that age are sponges for the emotional atmosphere. Yes, is the short answer to all the possibilities you’ve mentioned for her reaction. Trust yourself. If it feels very different for her normal personality — bring it to the attention of your pediatrician. The physician is in the best position to assess whether or not a psychological assessment is the right thing. Don’t wait. If she does need some help with the adjustment you’ll want to deal with it sooner rather than later.

]]>http://psychcentral.com/ask-the-therapist/2015/02/28/constantly-screaming-toddler/feed/0I Just Had a Baby and I’m Not Happyhttp://psychcentral.com/ask-the-therapist/2015/02/28/io-just-had-a-baby-and-im-not-happy/
http://psychcentral.com/ask-the-therapist/2015/02/28/io-just-had-a-baby-and-im-not-happy/#commentsSat, 28 Feb 2015 12:35:41 +0000http://psychcentral.com/ask-the-therapist/?p=34919

I just had a baby with my boyfriend, I’ve been really angry for no reason, when ever he gets home I’m all of a sudden angry, and he gets mad cause I complain to much about everything, I try to be happy, I don’t know what’s keeping me from being happy, I feel horrible because he does everything for me and the baby and I’m still not happy, I don’t want to lose my relationship and I feel like it’s headed in that direction

A: The first thing you do is go back to your OB/GYN. It may be that you are suffering from post partum depression. If that’s not the cause of your irritability, it could be that you are more overwhelmed by caring for a new baby than you realize. You are only 18. Infants, even the most beautiful and calm infants, are demanding little people. Many new mothers find that they weren’t prepared for the lack of sleep and the 24/7 nature of the job of being a mom. You may need some more practical help and emotional support.

I hope you have some older, wise, experienced moms you can turn to and talk to. If not, do look for a support group to help you, your boyfriend and the baby make the transition to being a family. You all deserve to enjoy what can be a very sweet time together.

I have really bad crazy dreams. Usually about death and graveyards. I dreamed once I was with a group digging up graves because we had to preserve them better and put them back. My papaw’s grave is always in these dreams. Why am I having them and what do they mean? … I have had major trauma and I suffer from depression, anxiety and OCD. I was just diagnosed with paranoid delusions. Thanks.

A. You have experienced major trauma and suffer from a number of mental health conditions. That could explain your disturbing dreams. Once your symptoms are more under control, you will probably have less frightening dreams.

Another cause of unsettling dreams is medication. You did not say whether or not you are taking medication but if so, this might also be the problem. Many medications trigger nightmares. Consult your doctor about your nightmarish dreams to see if they are potential side effects of the your medication. A medication change could help.

Until your symptoms are more under control, you should not regard your dreams as having much validity. Please take care.

For as long as I can remember, I have not been a good sleeper, but my insomnia has gotten much worse in the last decade or so. I try to soothe myself by imagining quiet, calm places, I’ve listened to mindfulness CDs and music. I’ve taken warm baths and showers. Nothing puts me to sleep except sleep medication, and sometimes not even then. What’s interesting is how I spend my time while trying to fall sleep: I imagine the most horrendous events, especially my death (usually suicide), or being abandoned by the people I love the most. I recognize that these fantasies are “terrifying me to wakefulness,” but I don’t understand why. I try to put these fantasies aside and focus on the calm images, but I also slip back to the terrors that keep me awake. Why do I do this? Do I not want to sleep? Does sleep frighten me? Though I’m seeing a therapist because I have a sex phobia, I don’t have any recollection of any abuse as a child, though my therapist has hinted that perhaps I’m keeping myself awake as a protective mechanism because something might have happened to me years ago while I was sleeping. Do you have any thoughts or suggestions? (age 61, from US)

A: I’m sorry you are having this trouble. Nothing is more frustrating than not being able to sleep well and it also affects our mental and physical health. I can’t be any more certain about WHY you aren’t sleeping than you. Your therapist may be right in that there may be some unconscious protective mechanism at play, it could be part of an anxiety disorder (imagining worst case scenarios), it could be learned behavior that has become a ritual, and finally, hormonal changes most certainly could be making it worse at this point in your life.

Rather than trying to figure out the “why,” I would suggest focusing your energy on new and different remedies. I know you have already tried many of the standards, so you may need to step outside of the box. Have you considered hypnosis, acupuncture, homeopathy, or energy work — such as Reiki? In addition, many medical centers now have multidisciplinary sleep disorder clinics and a quick internet search showed that your local medical school has one. I would encourage you to make an appointment for a complete sleep evaluation.

I hope these suggestions help and you find deep and restful sleep soon.

This issue I have is with my friend vie known him for about five years and in that fives he would talk about gay rights gay topics and make sexual innuendos and would insinuate that I was gay so I asked him if he was bisexual and he told me that he was straight but goes to gay bars and then later on tells me he was bisexual and the tells me few days later that he never said it so then he met his girlfriend at the time and he was gong to marry her and he wanted me to be his best man I was a bit freaked out by it but remained calm I then wrote him a letter telling me that I love him he responded to me that he wasn’t interested and he wanted to move on with his life and cut ties with me 3 months later we became friends again and he left his girlfriend and since then he told me that he cared about me not referencing that because we are friends he cares just said I care about you and we have been closer then ever and he’s very involve in my personal life and gets up set when we talk about things and I don’t follow through on them and also he tells me every thing that goes on in his life to the point that if he dies what he has cover he has for his kids and his ex wife also we talk to each other like we are all ready together if that makes sense- just need some advice on how to approach this because I don’t want to get hurt again and he also told me in the future he wants to sell his home and move to country and live there permanently why is he telling me this. If someone asked me if we were friends I would say yes but if I thought about it I wouldn’t know what to say because friends don’t do this to each other. (From Australia)

A: Your friend sounds like he is confused about his sexuality, along with his life’s direction. I wouldn’t place too much stock in making plans that include intimate partnership with him. Friendship, perhaps, but he doesn’t sound like he is focused on being together with you.

Rather than using him as a North Star in your life it may be better to think more about what is important to you, and what kind of relationship you need in your life. Individual counseling can help with this.

2 years ago I developed social anxiety out of the blue, and it was truly something I had never experienced. I had all of the symptoms of social phobia during the summer after 9th grade, and after weeks of experiencing it, I became depressed and really angry. When school started, I developed some ways to help deal with it, such as convincing myself that nothing was wrong with my face, and I reduced my social phobia significantly. However, I also began to have OCD alot more, fearing that I would get anxiety if I didn’t perform my rituals. Eventually my mother helped me get treatment for my OCD, and for the past 4 months (I am 16 and a half right now) I have had little to no OCD (compulsions and obsessions). These past 2 months, however, I have realized that my life hasn’t felt the same since my social anxiety. I still don’t speak as wittily and on command as I used to, and I notice that I ask obvious questions and that I mimic what other people say. I used to have my own way of speaking and thinking, and I feel like its hiding somewhere, but I don’t know how to bring it back. I don’t get scared around people like I used too, but I know that my social phobia is still there, and its blocking me out. However, I feel like its been so long since I’ve been myself (about 2 years) and I don’t know who I am anymore. I keep thinking that i have lost all my opinions and that I am a fake and I’m worried this is something bigger. I wake up several times at night, and sometimes the center of my head, around where the hippocampus is, feels heavy and I get sad. All my life, until I was 15, I got all A’s and B’s, but my grades dropped during that intense OCD phase and now I feel like an idiot and worry about my future. Everyday I think about how I have lost my personality and identity, and life feels unfamiliar to me. I don’t feel the need to hang out with friends or make new ones because I hate the way I talk, and how not-genuine I have become. I used to love to hangout with friends and even my parents, but nothing feels the same anymore and I don’t know who I am. I used to have interests and think about the future but all I do is think about the past and how good it was. I feel as if I mimic others and that my thoughts are infected with other peoples. I just have no idea how I became so lazy in school and I feel as if my developement is being hindered as a result. Can this all be anxiety, or is it something else? (age 16, from US)

A: Thank you for writing in with your question. Yes, everything you are struggling with can be related to anxiety. Anxiety disorders can affect our functioning a great deal and can take a long time to fully recover from. Even though there are distinct diagnostic differences, such as the ones you describe here with Obsessive Compulsive Disorder (OCD) and Social Anxiety, the lines can also be blurry and cross over.

I’m glad that you are getting treatment but you didn’t say whether it was medication or therapy. Receiving both forms of treatment would be ideal in this situation and you may need to remain in treatment for a while. Please be very open and honest with your therapist about all your symptoms because they can’t help you with aspects they don’t know about. Tell your therapist about your social anxiety, about your grades dropping, about your sadness and worry, your sleep difficulties and so forth. You might also benefit from finding a support group for adolescents coping with depression or anxiety. It can be very helpful to be around others who understand. There are usually many support groups offered within a community but you can also find them online.

Don’t worry if you don’t fully feel like your “old” self. You are still at an age that you are continuing to develop and grow. Be open to new experiences and be proud of yourself for fighting back. Don’t give up hope. Things will continue to get better.

My mom has been acting strange for a few years with her symptoms gradually getting worse every year. She kicked every family member out of her house and lives alone now. Whenever I’m around her I notice she will mumble or giggle to herself. She has theories that ALL television shows have secret messages about the afterlife and every single thing they say on TV has a hidden meaning. She now thinks we can communicate to her with our thoughts. She is 40 years old. She will call us by different names and sometimes will yell at us saying that we’re not who we say we are. She also frequently tells us that she’s a member of the FBI or that she’s secret agent and also that she doesn’t need a job because a rich family member is going to give her money. I was reading symptoms of schizophrenia and I noticed she matched a lot of them except for a few. She has great hygiene and she dresses well. She is also a bit narcissistic and admires herself in the mirror often. She will sometimes tell us she needs to see a psychiatrist but when we get someone who will see her she will refuse to go and will scream if we insist. Do these sound like Schizophrenic symptoms?

A. You have described symptoms of psychosis, which may be indicative of a psychotic disorder, such as schizophrenia. The only way to know if she has schizophrenia or any mental health disorder would be for her to undergo a mental health evaluation. Without an in-person evaluation, it’s impossible to determine an individual’s diagnosis.

Her symptoms are undoubtedly concerning. Try your best to convince her to seek mental health treatment. The ultimate goal is to convince her to voluntarily seek treatment. Otherwise, there may be little else that can be done. Forcing someone to seek treatment is very difficult and typically can only be done in emergency situations. In most cases, an individual cannot be forced into treatment unless they are a danger to themselves or to others. Short of that, an individual typically has a right to refuse treatment even if they are experiencing symptoms of psychosis.

You said that she lives alone. You want to do your best to make sure she’s safe. Check on her or send someone else, whom she trusts, to check on her. You may want to contact your local community mental health center to determine if there are services available that can assist your mother or family.

If you are worried about her immediate safety, call the authorities or your local mental health crisis team. They can go to her home and evaluate her mental health status. If she were to need hospitalization, that can be arranged by the mental health crisis team.

If you have additional questions, please don’t hesitate to write again. Please take care.

Friday night I started having an anxiety attack. I dont remember a whole lot. The next thing I remember I was a child holding my boyfriend and sobbing uncontrollably as if something bad had happened to me. Then my boyfriend said I sat up and said I don’t know who I am. Tell me who I am. He said he showed me pictures of the kids and I and I didn’t recognize any of them and I said that wasn’t me. I remember curling in a ball at some point and saying please stop, I am sorry. My boyfriend said he asked why I was sorry and I was picking and said I don’t know, I am sorry. I remember a flash back of being smothered, and saying I cant breathe, I cant breathe! Then I felt like I was someone else looking at myself. I dont remember the rest. I am afraid this will happen again. And I want know what this is. I don’t want to forget who I am. I am scared. (age 36, from US)

A: This experience does sound very scary and I’m sorry that it happened. There could be lots of explanations but it sounds like you might have had a flashback and a dissociative experience, which are generally caused by some type of severe trauma. Sometimes people can experience depersonalization (not feeling like yourself) with bouts of extreme anxiety or depression, but this experience seems to include elements beyond just that.

Due to the severity of the experience, I would highly recommend that you seek professional counseling. I suggest that you seek a therapist who specializes in trauma, even if you don’t have memories of being traumatized. Our mind can do wondrous things to protect us and sometimes the information begins resurfacing when we are strong enough to handle it. I hope you can eventually make some sense of the situation and I also hope that it doesn’t happen again.

From Lebanon: More than a year ago I suddenly started experiencing painful penetrations. A few days later I found out I’m pregnant. Doctor advised not to have sex during pregnancy because of pain. Now my baby is 6 months old and I still cannot have sex. Doctor said it’s a phobia or vaginismus. any recommendations? I think that my OB underestimated my complaints in the first place, if he had treated the issue back then things wouldn’t have reached this point. How can I help myself to overcome this issue?

A: The first thing I would suggest is a second opinion. Sometimes endometriosis causes this type of pain. Before treating you psychologically, I’d want to be sure that the problem isn’t physical.

If you are medically okay, I’d want to know what happened a year ago that changed things for you. That might lead us to determine what could be making you so anxious that sex has become painful.

Unfortunately, once someone has experienced painful intercourse, it is only natural for the body to brace against the possibility of more pain when the couple tries again to have sex. The anxiety then creates more pain. This can become a vicious circle.

I’m sorry your doctor advised against sex. In my opinion, he or she should have advised treatment. You should have had medical treatment if the problem is physical. You and your partner should have been referred for couples counseling to learn how to break the cycle of anxiety if that is the problem.

I’m sorry both you and your partner have been deprived of the closeness and intimacy that comes with a satisfying sex life. You both deserve that. And your baby deserves to have happy parents!